Evaluation of Fluoxetine in Refractory Constipation Treatment

The goal of this clinical trial is to determine if fluoxetine is effective in treating refractory constipation in adults. It will also assess the safety profile of fluoxetine when used for this condition. The main questions it aims to answer are: Does fluoxetine improve bowel movement frequency and Complete Spontaneous Bowel Movements (CSBM) in participants with refractory constipation? What adverse effects do participants experience while taking fluoxetine? Researchers will compare fluoxetine to a placebo (a look-alike substance that contains no active drug) to evaluate its efficacy and safety in treating chronic constipation. Participants will: Take fluoxetine or a placebo daily for 12 weeks Visit the clinic every 4 weeks for checkups and tests Maintain a diary of their CSBM, Spontaneous Bowel Movements (SBM), bowel movements, stool consistency, and any side effects experienced